Volunteer hospital chaplain Meryl Lanning looks in on a patient at S.F. General - a hospital whose unofficial motto is "It's as real as it gets." Chaplains buoy patients and loved ones in all kinds of situations.

Photo: Mike Kepka, The Chronicle

Volunteer hospital chaplain Meryl Lanning looks in on a patient at...

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Lanning shares a light moment with trauma nurse Kirsten Strait in the ICU at S.F. General.

Photo: Mike Kepka, The Chronicle

Lanning shares a light moment with trauma nurse Kirsten Strait in...

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Chaplain Meryl Lanning meditates with a patient in the San Francisco General Hospital ICU. Chaplains, no matter what their own religious persuasion, are trained to work with families of any faith - or no faith at all.

Anthony Yee was pretty sure he was going to die, and if he wasn't, he wanted to kill himself.

Guillain-Barre, an autoimmune syndrome, had left him immobilized and in immense pain in the intensive care unit at San Francisco General Hospital. At the time, Yee, 39, could communicate only by blinking.

But then he began meeting with the hospital's chaplaincy. Filled with existential questions about the value of his life, the chaplains helped him find conclusions and answers on his own.

Yee said the chaplains brought him out of his despair, and through that, he realized there was more he wanted to accomplish in life.

"When you're ill, you find out who your friends are," said Yee, who spent more than two months in the hospital's intensive care unit and has been in rehab for a year at Laguna Honda Hospital. "It's not that the people in your life don't visit, but a lot of times they don't know what to say. That's where people like Elizabeth come in."

Elizabeth is the Rev. Elizabeth Welch, an Episcopalian priest and the spiritual care coordinator of the Sojourn Chaplaincy at San Francisco General.

A petite woman with a big laugh, Welch, 34, tears up quickly when talking about the patients she has known in her six years helping to oversee the chaplaincy at the hospital.

The other full-time chaplain, the Rev. Bruce Lery, is a Catholic priest employed by the San Francisco Archdiocese but whose church, as he says, is the hospital. He used to lead a church in Hawaii, and on Fridays, he wears a Hawaiian shirt with a clerical collar poking out.

They are joined by about 15 trained volunteer chaplains of diverse faiths.

Guiding to answers

The chaplains are called on to assist people at the worst moments of their and their families' lives. They face questions ranging from "What happens when I die?" to "Why me?" to "Is God punishing me for my sins?" Their job is not to tell patients what they think, they said, but to guide them to answer the questions themselves and to accept what is happening.

And although they have their personal faiths, the chaplains are trained to work with patients and families of any, or no, faiths. Michael Goldman, a volunteer chaplain who spends most of his time in the hospital's jail, is Jewish, but said he carries rosary beads.

When not responding to emergencies, they walk the hospital's hallways popping into patients' rooms to check in, to see how they're coping and taking stock of how the medical staff is doing.

Sometimes patients assume they are there to proselytize, and Welch said she has introduced herself as the chaplain only to have a patient reply, "I didn't know I was that sick!"

Some patients ask for prayer, while some seek spiritual aid more generally. Others need more existential or psychological support. Some patients are slow to open up, and some say they do not want to see a chaplain. But "sometimes all it takes is to say, 'I'm here, my name is so and so and I'm the chaplain,' and someone will throw their arms around you sobbing," said Meryl Lanning, a volunteer chaplain.

'You're not alone'

"It's hard to express, but I think knowing that you're not alone in a crisis situation gives you some sort of comfort and aid," Lanning said. "And knowing that you're with someone who is going to deeply listen and really hear you and not in any way judge - that's huge."

Much of the job is to be there in moments of tragedy, but staffing and budget problems are putting after-hours, on-call chaplaincy at the hospital in some doubt, starting in January. Hospital officials say efforts are being made to avoid any interruption, but that if one happens, it will be brief.

Welch said the idea of not having a chaplain to come to the county's trauma and public hospital at all times is a "painful thing." She said she has gotten overnight calls from medical staff urging her to "please get here" to console parents who have lost a child.

"This is the trauma hospital," she said. "This is where things come in at 2 in the morning. And I hate to think of that stuff happening when there's no one to call."

As a public hospital, San Francisco General cares for many people who have been marginalized in one way or another. Many are poor or homeless or do not have reliable access to food. Some have substance abuse problems and histories of trauma. Others may have been kicked out of their families.

"And often all of that," Welch said.

Life at its most raw

"The General," as some of the chaplains call it, also receives many of the county's emergency cases - one of its unofficial mottos is "It's as real as it gets."

"Working with people when they're dying or when they're shot in the head, or when their lover or child or friend has been shot in the head - you can't bull- here," Lery said. "It constantly, constantly readjusts my attitude on life."

The chaplains can also serve as a resource for medical teams who struggle with particular cases. Dr. Heather Harris, a palliative care physician, told of how the chaplains organized a memorial service for a young man whom many of the staff had grown close to.

Interacting with family

"It was an enormous outlet for medical providers to have an avenue to talk to the family in a way that in your day-to-day care for patients is hard to do," she said.

Chaplains noted there can be joy even when there is death. Lery said one of the most rewarding experiences is seeing patients surrounded by family as they near the end of long and happy lives.

But the job exposes chaplains to much anguish, particularly when it comes to the death of a child. Welch said parents have screamed at her to tell God to bring their child back.

"It's so devastating for people and so unexpected," she said. "There's nothing you can say to make it better, there's nothing you can do to make it better. You can stand with them in their pain, you can hold them while they're crying."

Serving is an honor

The suffering chaplains are exposed to means that, as Goldman said, "Even chaplains need a chaplain."

Yet all of them said that they get much more out of chaplaincy than they put in. They described it as an honor to aid people when they need it most.

"It seems like such a privilege to get below the superficial and really see that person," said Shelley Chesley, a volunteer chaplain. "The guard comes down; the mask comes off."

"Where the pain and vulnerability lies, so does a lot of a person's grace and humanity," Lery said.

"One of the real gifts of chaplaincy is that it calls you to see people's wholeness - especially to see that in a situation when others see brokenness," Welch said.

Lanning described one elderly patient she met who was initially scared to die. She spoke with him about the fact that he was dying, and as he talked through his fears with her, he came to find peace.

"There's something very beautiful in that connection - something sacred," she said.